Anastomic urethroplasty in bulbar urethral stricture. 13 years experience in a department of urology. / Uretroplastia anastomótica en el manejo de estenosis de uretra bulbar. Experiencia de 13 años en un Servicio de Urología.

UNLABELLED: Urethral stenosis is a common disease in the clinical practice of urology, with a major impact on the quality of life of patients. The anastomotic urethroplasty is a technique with very precise indications usually membranous or bulbar urethra stenosis with a length of 3 cm or up to 7 cm when it is secondary to urethral disruptions (no stenosis) after pelvic trauma. OBJECTIVE: We review anastomotic urethroplasty performed in our department between 2002 and 2015. METHODS: A retrospective, descriptive and inferential analysis on 107 patients out of 482 treated with Anastomotic urethroplasty by urethral strictures at the Urology Department of the Hospital "Virgen de la Victoria" (Malaga) from January 2002 to September 2015, establishing effectiveness and safety of the technique, as well as factors that might influence the results. The main diagnostic method was retrograde urethrography and voiding cystourethrography in 100% of patients undergoing surgery, using voiding uroflowmetry for subsequent monitoring. The definition of success was a postoperative flowmetry with Qmax>15 ml/s, and in case of lower flow, we perform a cystoscopy to verify recurrence of stenosis or exclude other pathology. RESULTS: The median age was 42 years, with a mean follow up of 59 months. The length of stenosis valued by retrograde urethrography and voiding cystourethrography was in 91.6% of cases of >1 cm and <2 cm. The most common etiology was idiopathic in 72.9%, followed by iatrogenic with 15.9%. Regarding the location, it was observed that the area most often affected was the bulbar urethra with 82.2%, with the membranous urethra in second place. In 77.6% of patients anastomotic urethroplasty was the initial treatment, followed in frequency by direct vision internal urethrotomy 9.3%. In the case of comorbidities associated with treatment with anastomotic urethroplasty it was observed that only Diabetes Mellitus had a tendency to statistical significance, with p=0.092, not demonstrating such significance in the case of hypertension or when the subject presented Diabetes Mellitus together with hypertension. Finally, the intervention was successful in 102 cases (95.3%), with only 5 cases (4.7%) where it failed, 4 of them treated with a new Anastomotic urethroplasty, with resolution of the stricture. CONCLUSIONS: Anastomotic urethroplasty is the treatment of choice for short bulbar urethral stricture, with high success rate and low complication rate, as well as low recurrence of these.

Syringocele in adult patient. Case report.

OBJECTIVE: To describe one case of syringocele in an adult patient. METHODS/RESULTS: We report the case of a 26 year old man who presented frequency, hematuria and fever during one year, mictional cystourethrography showed a syringocele. Treatment consisted in endoscopic surgery, with good results in the follow-up. CONCLUSIONS: The syringocele is a relatively infrequent entity, that is necessary to study in a young patient with voiding symptoms, accompanied or not of haematuria and fever. The diagnosis is based on the cystourethrography, and treatment consisted, usually, in endoscopic surgery.

Siringocele uretral en adulto. A propósito de un caso / Syringocele in adult patient. Case report

OBJETIVO: Presentación de un caso de siringocele en la edad adulta. MÉTODO/RESULTADO: Describimos el caso de un paciente que consultó en nuestro centro por un síndrome irritativo vesical, hematuria y fiebre de un año de evolución, que en el seguimiento se objetiva mediante cistouretrografía miccional un siringocele simple. El tratamiento consistió en una marsupialización endoscópica, presentando buenos resultados en el seguimiento. CONCLUSIONES: El siringocele es una entidad relativamente infrecuente, pero que es necesaria tenerla en cuenta ante un paciente joven con clínica miccional, acompañada o no de hematuria y fiebre. El diagnóstico se basa en la uretrografía, y como modalidad terapéutica más habitual destaca la marsupialización endoscópica(AU)

OBJECTIVE: To describe one case of syringocele in an adult patient. METHODS/RESULTS: We report the case of a 26 year old man who presented frequency, hematuria and fever during one year, mictional cystourethrography showed a syringocele. Treatment consisted in endoscopic surgery, with good results in the follow-up. CONCLUSIONS: The syringocele is a relatively infrequent entity, that is necessary to study in a young patient with voiding symptoms, accompanied or not of haematuria and fever. The diagnosis is based on the cystourethrography, and treatment consisted, usually, in endoscopic surgery(AU)

[Villous polyp of the urethra]. / Pólipo velloso de uretra.

Villous polyps of the urethra are rare. This condition can be seen more frequently in patients aged 30-40 years. Hematuria is usually the major symptom. Generally, the polyps are localized in or around the verumontanum and do not recur after TUR or electrocoagulation. A case of villous polyp of the verumontanum is described in a patient who presented with symptoms and signs of obstructive micturition. The patient continues to be asymptomatic 6 months following treatment by electrocoagulation.

[Emergency conservative surgery in rupture of angiomyolipoma of the kidney]. / Cirugía conservadora de urgencia por rotura de angiomiolipoma renal.

A case of spontaneous perirenal hematoma from a ruptured angiomyolipoma is described. Diagnosis was made at the time of presentation and treatment was by conservative surgery. The different diagnostic methods and treatment of this condition are discussed.

[Activity of total cholesterol and its HDL fraction in vasectomized patients. A 3-month follow-up]. / Estudio del comportamiento del colesterol total y su fraccíon HDL en pacientes vasectomizados. Tres meses de seguimiento.

Vasectomy is an ever-increasingly used contraceptive method owing to its effectiveness and easy execution, although various studies have questioned its innocuousness. We have studied various parameters in 70 patients three months before and after the vasectomy was performed. The analytical factors controlled were as follows: glycemia, triglycerides, total cholesterol, HDL-cholesterol, LDL cholesterol, FSH, LH, testosterone and estradiol. Other data handled were arterial tension and body weight index. We questioned them about physical activity, distributing them into three groups, and about family history of arteriosclerosis, distributing them into two groups. Three months after the operation we found an increase in body weight index of 24.11 +/- 2.49 to 24.77 +/- 2.51, with a p less than 0.01. Total cholesterol also rose from 201 Cae 39 mgr% to 208 +/- 38 mgr% with a p less than 0.05. We also observed a drop in arterial tension. Patients with no family history of arteriosclerosis had an increase of total cholesterol of 199 +/- 39 mgr% to 210 +/- 35 mgr% with a p less than 0.001. In the heavy smoker group, total cholesterol also rose from 203 %/- 48 mgr% to 214 +/- 40 mgr% with a p less than 0.05. We discuss our results and our surgical complications and our conclusion in that, based on our study, we cannot assert the vasectomy plays a role as a risk factor of arteriosclerosis.